Dropping Patients, Failing To Secure Wheelchairs & Dangerous Driving Put Elderly Patients At Risk Of Further Harm During Ambulance Transport

Very few people consider the journey to or from a nursing home.  Unfortunately, what may be an afterthought for many, has turned into a nightmare for others when they  where injured during ambulance transport. Over the years, I have seen many errors made by ambulance drivers and attendants that has resulted in severe injuries to my clients.

In a pending matter, my law office was retained by the family of a man who was being transported from a nursing home to an out-patient dialysis center by a private ambulance company.  During a short ride, the driver of the ambulance lost control of the vehicle and the ambulance flipped into a roadside ditch.  Because, our elderly client was not secured in the ambulance, he was literally thrown out of the ambulance and sustained catastrophic injuries.

The medical condition often dictates whether a nursing home patient will be transported via a private ambulance company or a municipal ambulance.  In either case, public and private ambulances owe a very high degree of care to the people they transport-- be it around the corner or across the state.

Nevertheless, most states have different laws that apply to private ambulance companies (and medicar / medivan tranportation) as opposed to municipally operated ambulances.  Therefore, it is important to learn as quickly as feasible, the type of ambulance and personnel involved in an incident to determine which laws apply.

Public Ambulance Liability

Emergency medical services (EMS) are necessary for those emergency medical situations that occur out of hospitals. Ambulances can quickly and effectively transport a patient while providing medical services along the way. Many times, this medical care saves lives. But other times, negligent driving and medical mistakes can injure or even kill the patients that the ambulance was meant to save. 

Emergency medical services (EMS) system refers to an organization of hospitals, vehicle service providers and personnel in a specific area, which coordinates and provides pre-hospital and inter-hospital emergency care and non-emergency medical transports. When responding to an emergency call, patient care and safety should be the first priority of all emergency medical services (EMS). 

In order to provide the highest quality of patient care, EMS must have well-trained Emergency Medical Technicians (EMT) and the appropriate equipment and supplies for ambulances. Patient care reports are very important in determining whether EMS providers acted accordingly. Oftentimes, they are the only document available to show what the paramedics did on a call, how they did it, and why they did it. 

Immunities Available to EMS Providers

EMS Providers are not liable for injuries unless their behavior is characterized as willful and wanton misconduct under Section 3.150(a) of the Illinois Emergency Medical Services (EMS) Systems Act. This Act applies directly and specifically to EMS providers.

The Local Governmental Employees Tort Immunity Act (745 ILCS 10 ) protects local governments and their employees from litigation if they fail to or inadequately examine, diagnose, or treat any person, as long as that failure occurs within the scope of employment. The Emergency Medical Services (EMS) Systems Act (210 ILCS 50/3.150) also grants EMS providers (including private and public ambulances) civil immunity from lawsuits for any act or omission in providing emergency or non-emergency medical services. However, it contains an exception for willful and wanton misconduct. 

In Abruzzo v. City of Park Ridge, No. 104935 (Oct. 2, 2008), the Illinois Supreme Court was asked to resolve this conflict between the Tort Immunity Act and the EMS Systems Act. In this case, paramedics from the City of Park Ridge responded to a call for a non-responsive patient; this patient ended up being a 15-year-old boy who had suffered from an overdose. Upon arrival, the paramedics did nothing to assist the patient; they failed to evaluate, assess, examine, diagnose, treat, or document the boy’s condition, and the boy died the next day. 

The Illinois Supreme Court determined the boy’s mother could pursue a wrongful-death suit against the city for the alleged willful and wanton misconduct of its paramedics because the limited immunity provision in Section 3.150(a) of the Emergency Medical Services Systems Act applied to this case, not the absolute immunity provisions of Sections 6-105 and 6-106 of the Tort Immunity Act.

Properly loading patient and driving safely

Under the Illinois Tort Immunity Act (Section 5-106), except for willful and wanton misconduct, EMS providers are not held liable for an injury caused by the negligent operation of a motor vehicle or firefighting or rescue equipment, when responding to an emergency call, and this includes the transportation of a person to a medical facility. In addition, the EMS Services Act (210 ILCS 50/3.150) also provides that no person, agency, or governmental body certified, licensed or authorized pursuant to the Act, who in good faith provides emergency or non-emergency medical services will be held civilly liable as a result of their acts or omissions in providing such services, unless it constitutes willful and wanton misconduct. 

Therefore, unless ambulance drivers or EMTs displays willful and wanton misconduct when responding to an emergency call, loading a patient into an ambulance, or transporting a patient to a medical facility, they will not be held liable for injury.

Responsibility for medical complications during transport.

EMS providers can be held liable for willful and wanton misconduct during the transport of a patient. The exemption from civil liability for emergency care is provided for in the Good Samaritan Act. (210 ILCS 50/3.150 (c). 

In Fagocki v. Algonquin/Lake-In-The-Hills Fire Protection District, 469 F.3d 623 (7th Cir. 2007), the Seventh Circuit Court of Appeals ruled that failing to properly intubate a patient in a moving ambulance does not constitute willful and wanton misconduct.   In this case, the court noted that misplacing the endotracheal tube while traveling in a moving ambulance would not be considered negligence. Furthermore, while the paramedics’ failure to discover the misplaced tube may have been negligent, it would not amount to willful and wanton misconduct without circumstances of aggravation. Therefore, the added difficulty of performing medical procedures and emergency care while in a moving ambulance is factored into the court’s reasoning when determining whether medical mistakes and complications are willful and wanton misconduct that could subject the EMS providers to civil liability. 

Ambulances and Emergency Medical Services are essential to providing proper medical care. However, when EMS providers act negligently in their handling and transport of patients, they can be held liable if their acts or omissions constitute willful and wanton misconduct. If you or a loved one suffered injuries or even death during an emergency or non-emergency transport by EMS providers, you may be able to bring a civil suit against those responsible. 

Resources:

Illinois Association of Fire Protection Districts: EMS Liability, Recent Changes in Illinois Law

American College of Emergency Physicians: EMS

Nursing Homes Abuse Blog Entries:

Ambulance Accident Claims The Life Of A Nursing Home Patient After Dialysis Treatment

Ambulance Stolen From Chicago Nursing Home Results In Multiple Injuries

Transportation In & Out Of Nursing Homes: Ambulance Responsibility.

Assisted Living Fall Leads To Wrongful Death Lawsuit

The family of an assisted living resident has filed a wrongful death lawsuit against the facility. 83-year-old, Luveda Fern Kessler, fell and cut her leg as she got out of bed at her Laguna Hills assisted living apartment. Ms Kessler did as she had been told to do: Press a personal emergency response call button, according to a recent lawsuit filed by her family.

The assisted living employee waited 24 minutes before calling 911.  During the 24 minutes Ms. Kessler lay bleeding and unassisted with any staff.  By the time the paramedics arrived, Ms. Kessler lay on her stomach, non-responsive. She was later pronounced dead at a local hospital.

Villa Valencia did not report the Aug. 23, 2007, incident to the state.  The incident led to a wrongful death lawsuit filed in Orange County Superior Court last month against Villa Valencia and its owner, Sunrise Senior Living Inc.  "They let my mom bleed to death,'' said Kessler's daughter, Joanne. "I thought that was the best place for her. … Her death was completely preventable."

Assisted living facilities are not intended to provide the same level of care as nursing homes.  Nonetheless, assisted living facilities are required to conduct assessments as to residents medical needs and provide assistance to residents who require it.  In this case, not only was there not a nurse to provide help, there was no staff to provide basic life saving assistance.  Read more about this incident involving assisted living under-staffing here.

Here is a transcript of 911 call regarding Kessler's injury, which was made at 1:57 a.m. Thursday Aug. 23, 2007.  The family should use this as evidence of the assisted living facilties neglect in court.

911:Fire emergency.

Caller:Yes, I have a resident in Villa Valencia and she fell off the floor - - she is bleeding on the floor.

911:Okay what is the address, please?

Caller:It's 25, sorry hold on - - - get that address for me quick - - just a moment - - are you there?

911:Uh-huh.

Caller:Hello?

911:Yes.

Caller:Oh, it's - - can you hear me?

911:I can, go ahead.

Caller:24552 Paseo de Valencia.

911:OK, which room number?

Caller:Sunrise, it's 226 A building.

911:Room number 226 in Building A.

Caller:Yes, 226.

911:OK, and the telephone number you are calling me from, please?

Caller: Pardon me?

911: The telephone number, please.

Caller:The phone number for here?

911: Yes, the one you are calling me from.

Caller:949-581-67 - -

911:No, the number you are calling me from, ma'am.

Caller:OK, I'll have to get her number.

911:Is there a nurse with the patient?

Caller:No, there's not a nurse here right now.

911:Who's with the patient?

Caller:I'm with the patient right now, and I don't know her direct number, I'm using the number for the - -

911:OK, I have help on the way for you. How old is she?

Caller: I don't know her age right now - -

911:- - give me your best guess.

Caller: Can you - -

911:- - give me your best guess.

Caller:Around 81.

911:81. Is she conscious?

Caller: She's conscious.

911:Is she breathing OK?

Caller: She's breathing. Get her …for me quick.

911: OK. And what is she - - she fell off the bed?

Caller:Yes, she fell off the bed.

911:And she's bleeding from where?

Caller: Her foot. She always has problems with her foot.

911:OK, are you able to control the bleeding (2:15) with some pressure.

Caller:I'm trying to find it right now.

911:You're trying to find what right now?

Caller: The bleeding, where it's coming from.

911:OK.

Caller: I just walked into the room not too long.

911:OK.

Dispatch:This is 18 we don't need to go, right

911: No.

Dispatch: All right, I'm going to disconnect.

911:All right. Thanks.

911:What you need to do is find several clean, dry cloths, apply direct continuous pressure to her foot

Caller: Yeah, OK.

911: - - to control the bleeding. Are you able to do that for me?

Caller:Yes, yes.

911: OK. All right, we should be there in a few minutes if anything changes (2:45) call us right back.

Caller: OK.

911:Thank you.

Caller:Bye-bye.

Sun Rise Senior Living is a publicly traded company that runs 445 senior centers internationally including 23 in Illinois.

Medical Helicopter Safety

The crash of a medical helicopter in Indiana is a reminder of the potential dangers to nursing home residents during transport.  This recent helicopter crash occurred in rural Indiana with a Air Evac Lifeteam.  Three people died in the helicopter crash including a flight nurse, flight paramedic and base manager.  No patients were on board.  The FAA is investigating the cause of this tragedy.

Transportation In & Out Of Nursing Homes: Ambulance Responsibility.

Unfortunately for many nursing home residents, their trip to the nursing home or out for a doctor's appointment can be riddled with problems during transport and is a frequent source of injury (while being transported via: ambulance, medicar or medivan). 

Like nursing homes themselves, ambulances and paramedics are regulated by Medicare.  Ambulances and their crews must also comply with state and local laws.  Ambulances transporting nursing home residents must:

  • Be capable of transporting people for in acute medical conditions
  • Must contain: stretcher, linens, emergency medical supplies, oxygen equipment, warning sirens, 2-way voice radio or wireless telephone
  • Must be staffed by trained personnel

Ambulances and their crews must trained to deal with a variety of both critical and non-critical situations.  Nonetheless, common ambulance / paramedic injuries include:

  • Dropping patients
  • Medication errors
  • Untimely response time for critical incidents
  • Failure to follow protocol for specific incidents
  • Failure to have required equipment
  • Failure to properly make initial assessment
  • Failure to monitor vital signs
  • Helicopter accidents
  • Automobile accidents
  • Wheelchair-lift incidents
  • Physical abuse

If you believe you or a family member is a victim of paramedic negligence, you should contact an attorney who concentrates in cases involving paramedic / ambulance injury to learn your rights under Federal and State law.